Indications

• Ulnar impaction syndrome
  
• Positive ulnar variance from radius malunion (e.g., distal radius fracture)
  
• Traumatic lunotriquetral interosseous ligament tear with positive or neutral ulnar variance

Preoperative Evaluation

• Measure ulnar variance with shoulder abducted 90 degrees, elbow flexed 90 degrees, and forearm and wrist in neutral positions.

Figure 27-1

Technique

To improve bone healing, do not strip the flexor carpi ulnaris (FCU) except at the osteotomy site and for applying plate clamps.